[Phacoalternative Cataract Surgery At The Bartimée Clinic In Conakry (Guinea)]. / Chirurgie De La Cataracte Par Phacoalternative A La Clinique Bartimee A Conakry (Guinee).

The purpose of this work was to evaluate the results of phacoalternative. METHOD: This was a four-month analytical descriptive study. Our variables were socio-demographic, clinical, paraclinical and evolving. Patients operated by Phacoalternative during the study, having consented, were included. Not included were the operated patients who did not follow up. RESULT: The average age was 61.37 ± 8.3 years, the sex ratio 1.06 of which 63.9% came from Conakry, 57.6% were out of school and 39.9% were housewives. Diabetes was the most common comorbidity 23.75%. The fundus was inaccessible in 66.4%. The average biometrics were 22.60D. The right eye was more operated on or 53.5%. The most common postoperative complication was the 4.5% cloudy cornea. There were no complications at D1 in 88.3% and at D14 in 98.8%. The mean of preoperative Astigmatism 1.07D < to the mean of postoperative astigmatism 1.6D.Preoperative visual acuity was < 1/10 in 78.8%, between 1/10 - 2/10 in 11.5% and ≥ 3/10 in 9.7%. Postoperative visual acuity was < 1/10 in 2.0%, between 1/10 - 2/10 in 10.0% and ≥ 3/10 in 88.0%. CONCLUSION: The phacoalternative is the ideal method. However, the acquisition of Phacoemulsifiers could improve these results.

Le but de ce travail était d'évaluer les résultats de la phacoalternative. METHODE: Il s'agissait d'une étudedescriptiveanalytiquede quatre mois.Nosvariables étaient socio-démographiques, cliniques, paracliniques et évolutives.Ont été inclus, les patients opérés par Phacoalternative pendant l'étude, ayant consenti. N'étaient pas inclus, les patients opérés n'ayant pas respectéle suivi. RÉSULTAT: L'âge moyen était de 61,37 ± 8,3 ans, le sex-ratio 1,06 dont 63,9% provenaient de Conakry, 57,6% étaient non scolarisé et 39,9% étaient ménagères. L'hypertension artérielle était la comorbidité la plus fréquente 23,75%. Le fond d'œil était inaccessible chez 66,4%. La moyenne de la biométrie était 22,60D. L'œil droitétait plus opéré soit 53,5%. La complication post-opératoire la plus fréquente était la cornée trouble 4,5%. Il n'y avait pas de complication à J1 chez 88,3% et à J14 chez 98,8%. La moyenne d'Astigmatisme pré-opératoire 1,07D < à la moyenne d'astigmatisme post-opératoire 1,6D. L'acuité visuelle pré-opératoire était < 1/10 chez 78,8%, comprise entre 1/10 - 2/10 chez 11,5% et ≥ 3/10 chez 9,7%. L'acuité visuelle post-opératoire était < 1/10 chez 2,0%, comprise entre 1/10 - 2/10 chez 10,0% et ≥ 3/10 chez 88,0%. CONCLUSION: La phacoalternative est la méthode idéale. Cependant, l'acquisition de Phacoémulsificateurs pourrait améliorer ces résultats.

Comparison of the outcomes of cytoreductive surgery versus surgery plus hyperthermic intraperitoneal chemotherapy for peritoneal carcinomatosis: a propensity score matching analysis.

BACKGROUND: Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) are effective treatment options for selected patients with peritoneal carcinomatosis (PC). We compared the short-term outcomes of surgery plus HIPEC and CRS alone for PC. METHODS: We retrospectively examined patients who underwent CRS-HIPEC for PC at a single center from 2014 to 2019 using the Chinese CRS-HIPEC patient database at our institution. Patients were divided into two groups: surgery plus HIPEC (450) and surgery alone (200). A 1:1 propensity score matching (PSM) analysis was performed. The postoperative outcomes, mortality, and length of hospital stay were compared between the surgery plus HIPEC and CRS alone groups. RESULTS: Propensity scoring generated 162 pairs. There was no statistically significant difference in the 30-day mortality rate between the groups (0% vs 0%, P = 1.000), and the morbidity rates were similar in both groups (7.4% vs 8.0%, P = 0.835). The surgery plus HIPEC group had a longer operative time (247.81 ± 64.70 vs 184.55 ± 29.56, P ≤ 0.001) and a slightly longer postoperative hospital stay (14.64 ± 5.24 vs 12.59 ± 3.76, P ≤ 0.001). No other baseline characteristics were significantly different. CONCLUSIONS: Surgery plus HIPEC is feasible for select patients and is associated with prolonged surgery times and prolonged hospital stays, and there is no significant difference in mortality rates or postoperative outcomes.

Risk factors for loss to follow-up, transfer or death among people living with HIV on their first antiretroviral therapy regimen in Mali.

OBJECTIVES: Risk factors for loss to follow-up (LTFU) were assessed for people living with HIV (PLHIV) at various reference out-patient clinics (expertise level II) and hospitals (expertise level III) in Mali. METHODS: HIV-1-positive adults starting antiretroviral therapy (ART) in 2006-2013 were eligible for inclusion. Risk factors for LTFU, defined as no visit in the 6 months preceding the last database update, were assessed with the Cox model, taking into account the competing risks of transfer and death. Potential risk factors at the start of ART were demographic and socioeconomic variables, World Health Organization (WHO) stage, CD4 count, period of ART initiation, type of ART, region of care, expertise level and distance from home. RESULTS: We included 9821 PLHIV, 33% of whom were male, starting ART at nine out-patient clinics and seven hospitals [five and two in the capital Bamako and four and five in the 'regions' (i.e. districts outside the capital), respectively] with a median (interquartile range) CD4 count of 153 (56-270) cells/µL. Five-year cumulative incidences of LTFU, transfer and death were 35.2, 9.7 and 6.7%, respectively. People followed at Bamako hospitals > 5 km from home, at regional hospitals or at regional out-patient clinics < 5 km from home were at higher risk of LTFU than people followed at Bamako out-patient clinics, whereas people followed at regional out-patient clinics 5-50 km away from home were at lower risk for LTFU. Deaths were less frequent at hospitals, whether in Bamako or in the regions, than at Bamako out-patient clinics, and more frequent at regional out-patient clinics. CONCLUSIONS: Expertise level and distance to care were associated with LTFU. Stigmatization may play a role for PLHIV living close to the centres in the regions.

Prevalence, management and ethnobotanical investigation of hypertension in two Guinean urban districts.

ETHNOPHARMACOLOGICAL RELEVANCE: Hypertension is an important public health challenge in low- and middle-income countries, and in many African countries including Guinea medicinal plants are still widely used for its treatment. MATERIALS AND METHODS: The objective of this study was to determine the prevalence of hypertension in two Guinean urban districts (Pounthioun and Dowsare), to describe its management and to collect information on traditional herbal remedies. A total of 316 participants entered the study, 28.2% (89/316) men and 71.8% (227/316) women. Of these, 181 were from Dowsare (50 men and 131 women) and 135 from Pounthioun (39 men and 96 women). The mean age of subjects was 40.8 ±â€¯14.0 years (range18 - 88years), while the majority of subjects (63.3% or 200/316) were 45-74 years old. RESULTS: The overall prevalence of hypertension was 44.9% (142/316): 46.4% (84/181) from Dowsare and 43.0% (58/135) from Pounthioun. Ethnobotanical investigations among hypertensive patients led to the collection of 15 plant species, among which Hymenocardia acida leaves and Uapaca togoensis stem bark were the most cited. Phytochemical investigation of these two plant species led to the isolation and identification of isovitexin and isoorientin from H. acida, and betulinic acid and lupeol from U. togoensis. CONCLUSION: The presence of these constituents in Hymenocardia acida leaves and Uapaca togoensis stem bark may at least in part support their traditional use against hypertension in Guinea.

Impact of poorly controlled epilepsy in the Republic of Guinea.

PURPOSE: To characterize people with epilepsy (PWE) presenting to a free neurology consultation and antiepileptic drug (AED) service in the Republic of Guinea. METHODS: Guinea is a low-income country in West Africa that recently experienced an Ebola Virus Disease epidemic. Community-dwelling PWE were seen at a public referral hospital in Conakry, the capital city. During two visits in 2017, an African-U.S. team performed structured interviews and electroencephalograms and provided AEDs. RESULTS: Of 257 participants (143 children, 122 female), 25% had untreated epilepsy and 72% met our criteria for poorly controlled epilepsy. 59% had >100 lifetime seizures, and 58% reported a history consistent with status epilepticus. 38 school-aged children were not in school and 26 adults were unemployed. 115 were not currently taking an AED, including 50 participants who had previously taken an AED and stopped. Commonly cited reasons for AED discontinuation were perceived side effects, unaffordability, and unavailability of AEDs. Traditional medicine use was more frequent among children versus adults (92/143 vs. 60/114, p = 0.048). 57 participants had head injuries, 29 had burns, and 18 had fractures. In a multivariable regression analysis, >100 lifetime seizure count was strongly associated with seizure-related injury (p < 0.001). Burns were more likely to occur among females (p = 0.02). CONCLUSIONS: There is an urgent need to improve the standard of care for PWE in Guinea. Several missed opportunities were identified, including low use of AEDs and high use of traditional medicines, particularly in children. Targeted programs should be developed to prevent unintentional injury and improve seizure control.

Retrospective study of laparoscopic versus open gastric resection for gastric gastrointestinal stromal tumors based on the propensity score matching method.

BACKGROUND: Surgical resection with a free margin is considered the gold standard for the treatment of gastric gastrointestinal stromal tumors (GISTs). Previous studies about the advantages of laparoscopic resection versus open surgery have generally been non-randomized and retrospective and have some obvious shortcomings that could influence the veracity and reliability of the results. Therefore, the aim of this study was to evaluate the efficacy of laparoscopic resection in the treatment of gastric GISTs using the propensity score matching (PSM) method. METHODS: Between 2005 and 2014, 217 consecutive patients undergoing laparoscopic or open resection for gastric GISTs were enrolled in a retrospective, single-center study. Patient and tumor characteristics, intraoperative and postoperative characteristics, and oncologic outcomes were collected from a database. The efficacy of the laparoscopic approach was analyzed using the PSM method by comparing the clinical parameters of patients who underwent laparoscopic (LAP) and open resection (OPEN) procedures. RESULTS: After PSM, 88 patients involved in the analysis (44 LAP vs. 44 OPEN) were randomly matched (1:1) by tumor size, localization, disease course, body mass index, age, and gender. The LAP group was clearly superior to the open group in terms of intraoperative indicators and postoperative short-term efficacy. The incidence of postoperative complications in the LAP group was lower than in the OPEN group (4.5 vs. 18.2 %, P = 0.044). A survival analysis showed that there was no significant difference in the disease-free survival time between the two groups (χ 2 = 0.211, P = 0.646). CONCLUSION: These data should be processed using the PSM method in a non-randomized controlled trial (non-RCT) study. It is safe and feasible for patients with gastric GISTs up to 5 cm in size or located in the gastroesophageal junction to be treated with laparoscopic surgery.

Safety analysis of laparoscopic endoscopic cooperative surgery versus endoscopic submucosal dissection for selected gastric gastrointestinal stromal tumors: a propensity score-matched study.

BACKGROUND: Laparoscopic endoscopic cooperative surgery (LECS) is a safe alternative to endoscopic submucosal dissection (ESD) for select gastric gastrointestinal stromal tumors (GISTs) that are <2 cm in size. To date, there have been no randomized studies comparing the feasibility of these two techniques. Therefore, we compared their feasibility and safety using the propensity score matching method in this study. METHODS: This was a single-center, retrospective, propensity score-matched study of patients who underwent resection of selected gastric GISTs between 2004 and 2014. All patients underwent curative resection for pathologically diagnosed small gastric GISTs. The primary aim was to determine intraoperative complications and postoperative courses. To overcome selection biases, we performed a 1:1 match using five covariates, including age, gender, body mass index, Charlson comorbidity index, and tumor location, to generate propensity scores. RESULTS: In total, 32 patients treated with LECS and 102 patients treated with ESD were balanced into 30 pairs. The rate of intraoperative complications was significantly lower in the LECS group than in the ESD group (P = 0.029). LECS patients had less intraoperative bleeding than did ESD patients (15.0 ml [range 9.5-50.0 ml] vs. 43.5 ml [range 22.3-56.0 ml], P = 0.004). The two groups had similar postoperative courses. There was no difference in the reoperation rate between the two groups (P = 0.112). The ESD group had a shorter operating time than did the LECS group (41.5 min vs. 96.5 min, P < 0.001). However, during a follow-up of 57.9 (±28.9) months, the recurrence rate did not differ significantly between the two groups (0.0 vs. 6.7 %, respectively; P = 0.256). CONCLUSIONS: LECS for selected gastric GIST patients is feasible and is associated with a better intraoperative outcome and an equal postoperative course compared with the results of ESD.

Risk factors for pulmonary complications following laparoscopic gastrectomy: A single-center study.

The risk factors associated with postoperative pulmonary complications (PPCs) following laparoscopic gastrectomy have not been well studied. We sought to identify the risk factors for PPCs following gastric cancer surgery.A retrospective analysis was performed on all gastric cancer patients in a prospective database who underwent a laparoscopic gastrectomy from 2004 to 2014. The potential risk factors for PPCs were evaluated.PPCs occurred in 6.8% (83/1205) of patients and included pneumonia in 56 (67.5%) patients, pleural effusion in 26 (31.3%) patients, and pulmonary embolism in 1 (1.2%) patient. The multivariate analysis identified the following significant risk factors for PPCs: advanced age (odds ratio [OR] = 1.043, 95% confidence interval [CI] = 1.021%, 1.066%), chronic obstructive pulmonary disease (COPD) (OR = 17.788, 95% CI = 2.618%, 120.838%), total gastrectomy (OR = 2.781, 95% CI = 1.726%, 4.480%), time to first diet (OR = 1.175, 95% CI = 1.060%, 1.302%), and postoperative hospital stay (OR = 1.015, 95% CI = 1.002%, 1.028%). The risk factors for pneumonia included advanced age (OR = 1.036, 95% CI = 1.010%, 1.063%), total gastrectomy (OR = 3.420, 95% CI = 1.960%, 5.969%), and time to first diet (OR = 1.207, 95% CI = 1.703%, 1.358%). Only pancreatectomy was a risk factor for pleural effusion (OR = 9.082, 95% CI = 2.412%, 34.206%).The frequency of PPCs in patients with gastric cancer who underwent laparoscopic surgery was relatively high. Patients with cardiac and pulmonary comorbidities and those who undergo total gastrectomy and combined resection should be considered at high risk.

Prognostic impact of lymph node skip metastasis in Stage III colorectal cancer.

AIM: The aim of this study was to evaluate the prognostic impact of lymph node skip metastasis (LNSM) in patients with Stage III colorectal cancer. METHOD: Between April 2003 and December 2014, a total of 41 patients with lymph node skip metastasis (skip+) were compared with 86 patients with pericolic lymph node metastases [lymph node distribution (LND)1] and 57 patients with intermediate and/or main lymph node metastasis (LND2+3). All patients had radical D3 lymphadenectomy, performed either laparoscopically or as open surgery. RESULTS: The frequency of pT1-2 stage cancer was significantly higher in the skip+ group than in the LND1 group (26.8% vs 5.8%, P = 0.001). The number of metastatic lymph nodes in the skip+ group was lower than in the LND2+3 group (1.9 ± 1.5 vs 6.5 ± 6.0, P < 0.001). The 3-year disease-free survival (DFS) of the skip+, LND1 and LND2+3 groups was 64.8%, 69.7% and 40.1%, respectively (P = 0.008). The 3-year systemic recurrence rates of the skip+, LND1 and LND2+3 groups were 30.2%, 20.3% and 48.1%, respectively; (P = 0.002). Cox regression analysis revealed that preoperative carcinoembryonic antigen (CEA) of ≥ 5 ng/ml [hazard ratio (HR) = 2.2, P = 0.029], poor differentiation (HR = 3.8, P = 0.001) and skip+ (HR = 0.2, P = 0.021) were independently prognostic factors for DFS. CONCLUSION: The prognosis for the LND1-negative lymph node skip metastasis group was better than for the LND2+3 group and was comparable with that of the LND1 group after radical D3 lymphadenectomy.

[Clinical appearance and scalable profile Thiamine deficiency in prison in Guinea: study of thirty-eight observations]. / Aspect clinique et profil évolutif de la carence en thiamine en milieu carcéral en Guinée : étude de trente-huit observations.

Cardiovascular and neurological manifestations associated with thiamine deficiency in Guinean prisons are common but not reported.We performed a prospective study of 38 cases related to vitamin B1 deficiency over a period of 4 years. In this population, the literature of traditional data gathered: frequency peak after thirty (92.6%) and clear representation male (sex ratio M/F: 18/1). The clinical symptomatology remains essentially dominated by sensorimotor polyneuropathy and pure sensory (52.2%), overall heart failure (31.5%) and to a lesser degree by Gayet Wernicke's encephalopathy (7.8%) and shoshin beriberi with severe evolution (5.2%). The study of nutritional status by body mass index (BMI) of the World Health Organization, by the criteria of Detsky and biological markers including albumin, shows that these patients are severely malnourished.

Ethnomedical and ethnobotanical investigations on the response capacities of Guinean traditional health practioners in the management of outbreaks of infectious diseases: The case of the Ebola virus epidemic.

ETHNOPHARMACOLOGICAL RELEVANCE: The recent outbreak of Ebola virus infections has mostly remained confined to the West African countries Guinea-Conakry, Sierra-Leone and Liberia. Due to intense national and international mobilizations, a significant reduction in Ebola virus transmission has been recorded. While international efforts focus on new vaccines, medicines and diagnostics, no coherent national or international approach exists to integrate the potential of the traditional health practitioners (THPs) in the management of infectious diseases epidemics. Nevertheless, the first contact of most of the Ebola infected patients is with the THPs since the symptoms are similar to those of common traditionally treated diseases or symptoms such as malaria, hemorrhagic syndrome, typhoid or other gastrointestinal diseases, fever and vomiting. MATERIALS AND METHODS: In an ethnomedical survey conducted in the 4 main Guinean regions contacts were established with a total of 113 THPs. The socio-demographic characteristics, the professional status and the traditional perception of Ebola Virus Disease (EVD) were recorded. RESULTS: The traditional treatment of the main symptoms was based on 47 vegetal recipes which were focused on the treatment of diarrhea (22 recipes), fever (22 recipes), vomiting (2 recipes), external antiseptic (2 recipes), hemorrhagic syndrome (2 recipes), convulsion and dysentery (one recipe each). An ethnobotanical survey led to the collection of 54 plant species from which 44 identified belonging to 26 families. The most represented families were Euphorbiaceae, Caesalpiniaceae and Rubiaceae. Literature data on the twelve most cited plant species tends to corroborate their traditional use and to highlight their pharmacological potential. CONCLUSIONS: It is worth to document all available knowledge on the traditional management of EVD-like symptoms in order to evaluate systematically the anti-Ebola potential of Guinean plant species.

High level of HIV-1 resistance in patients failing long-term first-line antiretroviral therapy in Mali.

OBJECTIVES: In resource-limited settings, few data are available on virological failure after long-term first-line antiretroviral therapy. This study characterized the genotypic resistance patterns at the time of failure after at least 36 months of a first-line regimen in Mali, West Africa. METHODS: Plasma samples from 84 patients who were receiving first-line antiretroviral treatment and with an HIV-1 RNA viral load (VL) >1000 copies/mL were analysed. Genotypic resistance testing was performed and HIV-1 drug resistance was interpreted according to the latest version of the National Agency for HIV and Hepatitis Research algorithm. RESULTS: At the time of resistance testing, patients had been treated for a median of 60 months (IQR 36-132 months) and had a median CD4 cell count of 292 cells/mm(3) (IQR 6-1319 cells/mm(3)), a median HIV-1 RNA level of 28266 copies/mL (IQR 1000-2 93 495 copies/mL) and a median genotypic susceptibility score of 1 (IQR 1-4). The prevalence of nucleoside reverse transcriptase inhibitor (NRTI) and non-nucleoside reverse transcriptase inhibitor (NNRTI) resistance mutations was 78% and 82%, respectively. Viruses were resistant to at least one drug in 92% of cases. Although etravirine and rilpivirine were not used in the first-line regimens, viruses were resistant to etravirine in 34% of cases and to rilpivirine in 49% of cases. The treatment duration, median number of NRTI and NNRTI mutations and some reverse transcriptase mutations (T215Y/F/N, L210W, L74I, M41L and H221Y) were associated with the VL at virological failure. CONCLUSIONS: This study demonstrated a high level of resistance to NRTIs and NNRTIs, compromising second-generation NNRTIs, for patients who stayed on long-term first-line regimens. It is crucial to expand the accessibility of virological testing in resource-limited settings to limit the expansion of resistance and preserve second-line treatment efficacy.

Ethnobotanical survey on medicinal plants used by Guinean traditional healers in the treatment of malaria.

ETHNOPHARMACOLOGICAL RELEVANCE: The objective of the present study was to collect and document information on herbal remedies traditionally used for the treatment of malaria in Guinea. MATERIALS AND METHODS: The survey was carried out from May 2008 to September 2010 and targeted traditional medical practitioners and herbalists. The questionnaire and oral interviews were based on the standardized model which was prepared by the "Centre de Recherche et de Valorisation des Plantes Médicinales (CRVPM) - Dubréka". RESULTS AND DISCUSSION: A total of 258 people (141 males and 117 females) from which 150 traditional healers and 108 herbalists were interviewed. The age of informants ranged from 28 to 82 years old. 57% (149/258) of the interviewees were more than 50 years old. The respondents had good knowledge of the symptoms of malaria, and a fairly good understanding of the causes. One hundred thirteen plant species were recorded, out of which 109 were identified. They belonged to 84 genera and 46 families. The most frequently cited plants were Vismia guineensis, Parkia biglobosa, Nauclea latifolia, Harungana madagascariensis, Terminalia macroptera, Crossopteryx febrifuga, Terminalia albida, Annona senegalensis, and Nauclea pobeguinii. The leaves were most frequently used (80/113 species), followed by stem bark (38/113 species) and roots (4/113 species). The remedies were mostly prepared by decoction (111 species), followed by maceration (seven species). Only one species was prepared by infusion. CONCLUSION: The present study showed that traditional healers in Guinea have a consistent knowledge of antimalarial plants. Further research should be carried out to compare the anti-malarial activity of the different species, and to check if their use against malaria can be scientifically validated.

Subinhibitory concentrations of pinocembrin exert anti-Staphylococcus aureus activity by reducing α-toxin expression.

AIMS: Natural products have been used as potentially important sources of novel antibacterials in combating pathogenic Staphylococcus aureus isolates, a major problem around the world. In this study, we aimed to investigate the antibacterial effects of pinocembrin (PNCB) against Staph. aureus pneumonia in a murine model and its influence on the production of Staph. aureus α-haemolysin (Hla). METHODS AND RESULTS: The in vitro activities of PNCB on α-haemolysin production were determined using haemolysis, Western blot and real-time RT-PCR assays. The viability and cytotoxicity assays were performed to evaluate the influence of PNCB on α-toxin-mediated injury of human alveolar epithelial cells. Moreover, through histopathologic analysis, we further determined the in vivo effects of PNCB on Staph. aureus pneumonia in a mouse model. In vitro, PNCB at low concentrations exhibited inhibitory activity against α-haemolysin production and attenuated α-haemolysin-mediated cell injury. Furthermore, the in vivo findings demonstrated that PNCB protected mice from Staph. aureus pneumonia. CONCLUSIONS: We have provided new evidence of the effects of PNCB, which suggest that PNCB attenuated α-haemolysin-mediated cell injury and protected mice from Staph. aureus pneumonia. SIGNIFICANCE AND IMPACT OF THE STUDY: The findings indicate that PNCB may be used as a basis for anti-Staphylococcus agent.

[Management of ectopic pregnancy in Conakry, Guinea]. / Prise en charge de la grossesse extra utérine à Conakry (Guinée).

Ectopic pregnancy is one of the most frequent hemorrhagic emergencies encountered in gynecology and obstetrics. The purpose of this 16-month descriptive prospective study at the Ignace Deen Gynecology-Obstetric clinic at Conakry University Hospital in Guinea was to assess diagnostic techniques and therapeutic attitudes regarding ectopic pregnancy in a low-resource setting. The frequency of ectopic pregnancy was 1.4%. Mean patient age was 28.9 years. Ectopic pregnancy was often observed at the second or third pregnancy (47.1%) in women who were giving birth for the second or third time (36.0%) and had a history of sexually transmitted infections (88.2%) or abortions (43.1%). Most women had no schooling (60.8 %), were poor and lived in a marital home (86.3%). Presenting symptoms included the classic triad of amenorrhea (98.0%), abdominopelvic pain (92.2%), and vaginal bleeding (62.7%). Definitive diagnosis was achieved by ultrasound examination in 76.6% of cases and by puncture of the Douglas pouch in 84%. The most frequent site of ectopic pregnancy was the ampulla of the uterine tube (66.9%). Abdominal and ovarian pregnancy was observed in 3 and 4 of the 51 cases respectively. Surgical management was performed in all cases. The most frequent procedure was salpingectomy (80.3%). Proper treatment of sexually transmitted infections (STI), start-up of post-abortion care facilities, and provision of information during early consultation at the first signs of pregnancy would help reduce the frequency and improve the prognosis of ectopic pregnancy.

Prise en charge de la grossesse extra uterine a Conakry (Guinee)

La grossesse extra uterine (GEU) est l'une des principales urgences hemorragiques rencontrees en milieu gyneco-obstetrical. Les auteurs; dans une etude prospective; descriptive; d'une duree de 16 mois a la clinique de gynecologie obstetrique de l'Hopital Ignace Deen du CHU de Conakry; ont ressorti la place des moyens diagnostiques et degage les attitudes therapeutiques dans un contexte de travail ou les ressources sont limitees. La frequence de la GEU etait de 1;4; la moyenne d'age des patientes etait de 28;9 ans. Dans 47;1des cas; la GEU survenait a la deuxieme ou a la troisieme grossesse; chez les femmes qui accouchaient pour la deuxieme ou la troisieme fois (36;0) avec des antecedents d'infections sexuellement transmissibles (88;2) ou d'avortements provoques (43;1). Ces femmes etaient non scolarisees (60;8); issues de milieux defavorises et vivaient dans un foyer conjugal (86;3). La triade amenorrhee (98;0); douleurs abdomino-pelviennes (92;2); metrorragie (62;7) a ete la principale revelatrice de la GEU. L'echographie a ete concluante dans 76;6des cas et la culdocentese dans 84. Le siege de la GEU a ete le plus souvent ampullaire (66;7). Nous avons note 3 cas de grossesse abdominale et 4 cas de grossesse ovarienne sur 51 cas de GEU. Dans tous les cas la prise en charge a ete chirurgicale et le geste le plus frequent etait la salpingectomie (80;3). La prise en charge des IST; l'instauration d'unites de soins apres avortement et la sensibilisation a la consultation precoce devant les signes de grossesse contribueraient a la reduction de la frequence de la GEU et a l'amelioration de son pronostic

Ethnobotanical survey and antibacterial activity of some plants used in Guinean traditional medicine.

A total of 418 healers have been interviewed in Guinea, a coastal country of West Africa, ranging between 7 degrees 30 and 12 degrees 30 of northern latitude and 8 degrees and 15 degrees of western longitude. Plant species used by the local inhabitants to treat infectious diseases were identified using ethnobotanical, ethnographic and taxonomic methods. During these investigations, 218 plants were registered, of which the following were the most frequently used: Erythrina senegalensis, Bridelia ferruginea, Crossopteryx febrifuga, Ximenia americana, Annona senegalensis, Cochlospermum tinctorium, Cochlospermum planchonii, Lantana camara, Costus afer, Psidium guajava, Terminalia glaucescens, Uapaca somon and Swartzia madagascariensis. Most plants, and especially the leaves, were essentially used as a decoction. In order to assess antibacterial activity, 190 recipes were prepared and biologically tested, among which six showed activity (minimal inhibitory concentration<125 microg/ml) against Bacillus cereus, Mycobacterium fortuitum, Staphylococcus aureus, or Candida albicans, i.e., Entada africana, Chlorophora regia, Erythrina senegalensis, Harrisonia abyssinica, Uvaria tomentosa, and a mixture of six plants consisting of Swartzia madagascariensis, Isoberlinia doka, Annona senegalensis, Gardenia ternifolia, Terminalia glaucescens and Erythrina senegalensis.

[Four year management of HIV serology at the National Center of Blood Transfusion in Conakry]. / Bilan de 4 ans de sérologie VIH au Centre national de transfusion sanguine de Conakry.

From January 1997 to December 2000, 21145 blood donations have been collected and tested for anti-HIV antibodies by the National Center of Blood Transfusion of Conakry (NCBT). 347 were positive, confirmed by Western Blot (312 HIV-1, 20 HIV-2 and 15 HIV1-2). HIV seroprevalence in tested blood donations showed a slow decrease by year: 1.87% in 1997 to 1.79% in 2000. The distribution according to donation type was 1% for volunteer donors and 2% for family donors. Seropositivity HIV rates according to sex indicate that the female donors are more infected than male donors. Among 347 seropositive, 83% were more than 20 years old. The seroprevalence is higher in soldier blood donors 3.72% (53/1422) than in student donors 0.55% (43/7712). The number of seropositive results found during these 4 years is not really representative of the HIV spreading infection in Guinean population, but their distribution according to sex and age is very close to the distribution of the AIDS cases in Guinea.